CNA guide · updated 2026-09-29

How many questions are on the CNA written exam?

The NNAAP written exam used for CNA certification in Credentia states has 70 multiple-choice questions. Only 60 count toward your result; the other 10 are unscored pretest items. You get 2 hours to finish.

The format in one table

Part	Questions	Time
Written exam	70 multiple choice (60 scored, 10 pretest)	2 hours
Oral exam (alternative to written)	60 multiple choice + 10 reading comprehension (word recognition)	2 hours
Skills evaluation (separate)	5 randomly selected nurse aide skills	30 minutes in Pennsylvania, varies by state

What the 10 pretest questions mean for you

NCSBN places 10 pretest items on every written form to collect statistics before those questions are used for scoring on later forms. They look exactly like the scored ones, and you are not told which is which.

So answer every question as if it counts. In practice, your result rests on 60 questions, which means each scored item is worth about 1.7% of the scored exam.

Two hours is plenty if you pace it

120 minutes for 70 questions works out to a little over 1.7 minutes per question. Most candidates finish early, because CNA questions are short scenarios rather than long passages or calculations.

A simple pace check: by the 60-minute mark you should be past question 35. If you are, slow down and read each option carefully. Many wrong answers on this exam come from rushing past a word like "first", "best" or "most important".

How the 60 scored questions are split

The 2024 content outline gives both a percentage and an approximate item count for each area. Physical Care Skills is by far the largest domain.

Domain	Weight	About how many of 60
Physical Care Skills	64%	38
Psychosocial Care Skills	10%	6
Role of the Nurse Aide	26%	16

What the questions look like

Almost every item is a short situation followed by four options: a client refuses a bath, a resident with dementia becomes agitated, you find a client on the floor, a family member asks about a diagnosis. The exam checks whether you pick the safe, respectful action that stays inside the nurse aide role.

A reliable pattern: when a client's condition changes, the correct answer usually involves reporting to the nurse. When a client makes a choice you disagree with, the correct answer usually respects that choice and reports it. Options where the aide diagnoses, gives medication or changes the care plan are almost always wrong.

Written or oral: you choose

Federal rules require states to let nurse aides choose between a written and an oral exam. The oral version reads the questions aloud (on an MP3 player at test centers, or a recorded voice online) and adds 10 reading comprehension questions built from common job words. You must pass both the multiple-choice part and the reading comprehension part of the oral exam.

Choose the oral exam if reading English under time pressure slows you down. The content outline is the same.

Frequently asked questions

Is the CNA written exam 60 or 70 questions?

Both numbers are correct. You answer 70 questions, and 60 of them are scored. The 10 pretest questions are not identified.

Can I skip questions and come back?

Plan to answer every question. A blank answer cannot earn credit, so never leave one empty.

Does every state use the NNAAP?

No. The NNAAP is used in states that contract with Credentia. Other states use Prometric, Headmaster (D&S) or their own exams, with different question counts.

Try the free CNA practice test

Questions tagged to the official outline, with an explanation for every answer. 15 free a day, no sign-up.

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Sources: 2024 NNAAP Written (Oral) Examination Content Outline (NCSBN / Credentia) · Credentia NNAAP Handbook: The NNAAP Written (or Oral) Examination · 42 CFR 483.154 - Nurse aide competency evaluation. Independent study material. Not affiliated with or endorsed by NCSBN or Credentia.